Makindo Medical Notes

Distraction and other activities can help. Only really needs drug treatment if causing distress

Assessment

• Clinical Assessment: Thorough history and physical examination to understand the nature, frequency, and context of the hallucinations.
• Medical History: Review of past medical history, including neurological, psychiatric, and systemic conditions.
• Neuroimaging: Brain imaging (e.g., MRI, CT scan) to rule out structural abnormalities, tumours, or strokes.
• Laboratory Tests: Blood tests to check for metabolic disturbances, infections, or toxic substances.
• Cognitive and Psychiatric Evaluation: Assess cognitive function and psychiatric conditions, such as delirium, dementia, or psychosis.
• Medication Review: Evaluation of current medications for potential side effects or interactions that could cause hallucinations.

Table of Common Causes of Visual Hallucinations in Older Adults

Management

• Treat Underlying Conditions: Address any identifiable causes such as infections, metabolic imbalances, or medication side effects.
• Pharmacological Treatment:
  • Antipsychotics: Medications like quetiapine or risperidone may be used for hallucinations, particularly if linked to psychiatric conditions.
  • Cholinesterase Inhibitors: For hallucinations associated with dementia, medications like donepezil may help manage symptoms.
  • Adjust Medications: Modify or discontinue drugs that may be contributing to hallucinations.
• Psychosocial Interventions:
  • Psychotherapy: Cognitive behavioral therapy (CBT) can help manage distress and coping strategies for dealing with hallucinations.
  • Environmental Modifications: Ensure a safe and comfortable environment to minimize triggers or stressors that could exacerbate hallucinations.
• Supportive Care:
  • Education and Support: Provide education to patients and caregivers about hallucinations and coping mechanisms.
  • Monitoring and Follow-Up: Regular follow-up to monitor the progression and response to treatment, adjusting as necessary.